Commonwealth s Student Assistance Program (SAP):

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1 Office of Mental Health and Substance Abuse Services Bureau of Children s Behavioral Health Services May 2006 Cross-System Initiatives and Partnerships Commonwealth s Student Assistance Program (SAP): Pennsylvania is unique in its collaborative approach to offer a statewide infrastructure of support in all 501 school districts and 67 counties. SAP is a significant source of referral to services for children who previously went undiagnosed and untreated until their service requirements were the most severe. SAP is sponsored and funded at the local level through the Departments of Health, Education, and Welfare and is designed to assist school personnel in identifying issues including alcohol, tobacco, other drugs and mental health issues which pose a barrier to the student s success. Recently, the Pennsylvania Department of Education offered a new tool that enabled schools to develop their own websites that be link to the Commonwealth SAP website. Since this was so successful, the next step is to offer county coordination teams the same opportunity. For additional information about these and other SAP related issues, please see the SAP website at Youth Suicide Prevention Initiative: The Youth Suicide Prevention Initiative is a multi-system, statewide project consisting of flexible structures to initiate, promote and support suicide prevention efforts. The Youth Suicide Prevention Monitoring Committee consisting of a group of stakeholders with statewide responsibilities meets on a regular basis to define the primary objectives and provides leadership and direction to the larger initiative. The Youth Suicide Prevention Advisory Committee (a much larger group of stakeholders) meets quarterly and provides guidance for the initiative and has prioritized goals and objectives for the 2006 year. Five (5) working subcommittees were recently formed to accomplish objectives defined by the committee. 1) The Suicide Action Plan Subcommittee was created to review, revise and update Pennsylvania s Suicide Prevention Five Year Action Plan. 2) The Marketing and Advocacy Subcommittee will work to promote awareness at various venues including: conferences, forums, organized activities and through the dissemination of materials. 3) The Annual Suicide Prevention Awareness Week Subcommittee will coordinate events including a kickoff event at the Capital Rotunda on September 12, 2006 and community events across the state. 4) The Legislative Subcommittee will focus efforts to gain legislative awareness and support of statewide suicide prevention efforts. 5) The Funding Subcommittee will research and identify resources to fund state and local suicide prevention events and activities. 1

2 Suicide Prevention Grant Opportunity: DPW, Office of Mental Health and Substance Abuse Services, The Department of Health, and the Department of Education will partner with the other stakeholders in the Youth Suicide Prevention Initiative to apply for the Garrett Lee Smith Memorial Grant. The federal grant is offered specifically to develop or enhance youth suicide prevention efforts. Applications must be submitted by May 15, Education in Partial Hospitalization Programs: The Department of Education and the Department of Public Welfare are sponsoring a series of forums at various locations throughout the Commonwealth to inform school districts, partial hospitalization provider agencies, county and regional mental health staff, CASSP Coordinators, parents and advocates and stakeholders about the proposed changes as it relates to the education of children and youth in partial hospitalization programs. These forums are being hosted by Intermediate Units and are scheduled in March and April The purpose of the forums is to provide information to the above-mentioned community stakeholders of: 1) The commitment of the Departments of Education and Public Welfare to improve education services to children in partial hospitalization programs by means of proposed changes to the Public School Code, and proposed guidelines based on DPW regulations for providers of children s partial hospitalization programs. 2) To gather feedback and suggestions from the field through discussion groups on the positive and negative implications of these changes and, 3) To incorporate feedback into the development of new policy for these programs. DPW, Office of Mental Health and Substance Abuse Services and the Department of Education have proposed a Class 2. Bulletin, The Integration of Education in Partial Hospitalization Programs Operating During the School Day that interprets partial hospitalization regulations to ensure that children who are enrolled in partial hospitalization programs that operate during the school day have access to appropriate educational services. The proposed Class 2. Bulletin is posted for comment on the DPW website. DPW, Office of Mental Health and Substance Abuse Services, the Department of Education, advocates and other stakeholders have assisted with the creation of a proposed joint bulletin, Jointly Proposed Requirements For Mandating Interagency Planning For Children In Partial Hospitalization Programs. The bulletin is intended to provide guidelines on collaboration among systems, particularly between partial hospitalization providers and local education agencies, and to clarify roles and responsibilities of schools and providers in planning for the education and treatment for children who are enrolled in partial hospitalization programs during the school day. The proposed bulletin is posted for comment on the DPW website. 2

3 School Based Behavioral Health Initiative The Children s Bureau has been working with the Department of Education in crafting a strategy for:(1) Ensuring that schools are caring and supportive places that maximize learning as well as social, emotional, and behavioral development; and (2) Bringing together schools, county mental health programs, and community resources to develop a continuum of services that enable children to have their educational and mental health needs met within their school districts. The Department of Education and the Department of Public Welfare are sponsoring the first School-Based Behavioral Health Conference, to be held at the Holiday Inn Harrisburg/Hershey on May 3-5, The vision of the cross-agency conference planning team on School-Based Behavioral Health is to promote the academic achievement and well being of all Pennsylvania children, youth and young adults through the development of a comprehensive, school-based, cross-community, behavioral health support system. The conference will highlight local and national experts and leaders to address perspectives on behavioral health services in school settings, to provide information about innovative, model programs and to explore evidenced based practices. Information on the conference can be obtained at the PATTAN s Website at Transition Initiatives: The vision of the PA Community on Transition (PACT), through the Pa Training and Technical Assistance Network (PaTTAN), is that all Pennsylvania youth and young adults with disabilities will successfully transition to the role of productive, participating, adult citizens. Under the umbrella of the PACT, the Transition State Leadership Team (SLT) was formed out of the 1999 Memorandum of Understanding (MOU) between the Department of Education (Bureau of Special Education Programs and Bureau of Career & Technical Education), Department of Labor & Industry (Office of Vocational Rehabilitation, Bureau of Workforce Investment), Department of Public Welfare (Office of Mental Health & Substance Abuse Services, Office of Mental Retardation, Office of Children, Youth & Families, Office of Medical Assistance Program) and Dept. of Health (Bureau of Family Health, Bureau of Drug & Alcohol Programs). The purpose of the SLT working with the MOU was to develop an interdepartmental team that would work collaboratively to bridge program offices and fiscal issues to ensure services are provided to youth with disabilities. Membership has expanded from the original MOU agencies to now include youth and young adults, family members, advocates; and post-secondary education and juvenile justice representatives. On May 18 and 19, 2006 at the Hilton Harrisburg PA Youth Leadership Network PYLN) and the PA Training and Technical Assistance Network (PaTTAN), in collaboration with the Parent Education Network, the Parent Education and Advocacy Leadership Center, and the Transition State Leadership Team (Departments of Education, Labor & Industry, 3

4 Public Welfare, and Health, higher education, advocates, and families), will be hosting a Youth Outcomes Expo. The purpose of this event is to provide youth with disabilities a foundation in self advocacy, self determination, self efficacy skills, and leadership This event targets current high school sophomores from across the Commonwealth, and is designed to explore post secondary outcomes and promote self-advocacy, self determination, and self efficacy skills. The 5th Annual Pennsylvania Community on Transition Conference, Expanding Capacity: Realizing Outcomes will be held July 19-21, 2006 at the Penn Stater Conference Center and Hotel. The primary purpose of this conference is to expand the capacity of community partners in promoting the successful transition of youth/young adults with disabilities to post-school outcomes of: Employment Post-Secondary Education and Training Community Participation Healthy Lifestyles Registration information can be accessed through PaTTAN s website at Transition Age Pilot Program: The county transition pilots continue to operate and work with transition age youth in preparing them for adulthood. With the three year pilot coming to an end, the counties are working to develop unique strategies for their transition pilots. Staff from the Bureau of Children s Behavioral Health Services will continue to work closely with the counties to determine how they will be able to sustain the services for transition age youth that have been provided during the grant period. The Children s Bureau has made some staffing shifts to create a position with responsibility for transition. Doris Arena has been selected to fill this position which will be responsible for policy and program development to meet the unique needs of young people. Integrated Children s Services Planning (ICSP): The cross systems Integrated Children s Services Planning Project is now in its second year. All 67 county plans were reviewed in the fall and feedback from each review was sent out to counties. Regional staff is working on plans for helping counties continue with their integration efforts. A Youth and Family Subcommittee of the Integrated Children s Advisory Committee has been established to develop and monitor the implementation of a plan for insuring meaningful involvement of families and youth in the development of county integrated children s services plans. Membership is open to all youth and family members of the ICSP Advisory Committee. The guidelines for the fiscal year Integrated Children s Services Plan are expected to be released in May. Counties will be encouraged to continue to work 4

5 towards integration of all children s services, including showing evidence of how mental health, children and youth, juvenile justice, drug and alcohol, and mental retardation needs are to be met. PA System of Care Initiative (SOC): Pennsylvania s System of Care (SOC) Initiative is now in its third year. This grant under the Federal Administration for Children and Families (ACF) offered the opportunity for the Office of Children, Youth and Families (OCYF) in partnership with OMHSAS to provide focused leadership by organizing a process for developing SOC practices within Pennsylvania s county-based child welfare system. Dauphin County was selected as the primary county because of its strong Family Group Conferencing (FGC) capacity and the desire of key county human service leaders to organize programming and activities around SOC principles and practices. Initially nine other counties became involved with the awarding of mini-grants in March An additional 11 counties responded to a second round of requests for proposals in June of the same year. In total, 17 award letters were distributed to the following counties: Allegheny, Delaware, Elk, Lycoming, Northumberland, Jefferson, Armstrong, Luzerne, Erie, Cumberland, Juniata, Somerset, Mifflin, Indiana, Huntingdon, Venango, and Chester. This six year initiative will undergo both a national and local evaluation as required by the ACF. This month state and county teams will be meeting with officials from ACT during their site visit. An Evaluation Subcommittee consisting of parents, state and county staff has formed and is working with staff from the University of Pittsburgh Office of Child Development Division of Program Evaluation to develop a local evaluation. SOC is viewed as an integral component of a broad and comprehensive reform initiative to better design, organize, fund, manage, and deliver care through all child-serving systems. SOC principles and practices are the foundation of this reform effort. Those principles as outlined by Sheila Pires (Building Systems of Care: A Primer) specify that services should be: Comprehensive, incorporating a broad array of services and supports Individualized Provided in the least restrictive, appropriate environment Coordinated both at the system and service delivery levels Involve families and youth as full partners, and Emphasize early identification and intervention These align very well with the values, objectives and guiding principles of the President s New Freedom Commission on Mental Health. Integrated Children s Services Initiative (ICSI): This initiative (sometimes called MA Realignment) involves a concerted, as part of the DPW plan to identify children s behavioral health services, currently being paid by Child 5

6 Welfare funds that should be transitioned to Medical Assistance funding. Regional staff have been working with all counties to identify and facilitate the process of conversion. Changes have been made in the HealthChoices counties to reflect the increase in behavioral health services. Recently the focus has been on community based nonresidential services. This effort will support the integration of behavioral health services for children who are dependent or delinquent. Transformation Activities: Pennsylvania has been selected to be one of the states to receive training and technical assistance as part of the national effort to transform children s mental health systems to improve the well being of children and their families. The Georgetown National Training and Technical Assistance Center for Children s Mental Health, with the support of SAMHSA, is leading this initiative. Georgetown staff has been working with the Children s Bureau to: Assess the current status of the children s mental health system in Pennsylvania; Identify transformation targets and strategic opportunities; Facilitate collaborative alliances; and Develop action plans. The Georgetown consultants bring process and content expertise and provide links to national resources. Interaction and peer support with the other states that are part of this initiative will be available. This effort will bring focus, direction and support to the fundamental system change effort that is required for transformation. Children s Behavioral Health Task Force (CBHTF): Several months ago, the Children s Behavioral Health Task Force (CBHTF) Co-Chairs submitted a preliminary report on several issues at the request of Department of Public Welfare s (DPW) Secretary Estelle Richman. The Co-Chairs continued to work on these issues with staff from the Secretary s Office and the Children s Bureau. In addition, there has been an analysis of how the CBHTF subcommittee recommendations and the results of focus group sessions with youth and families are supported by research and practice principles, as well as an analysis of current opportunities, such as the Integrated Children s Service Planning process and the Integrated Children s Service Initiative. All of this work is part of the continued effort to develop a comprehensive draft report for the CBHTF that is expected to be available for public review in the near future. Children s Advisory Committee: The March 2, 2006 Children s Advisory meeting was canceled. The next meeting will be held on May 1, 2006 at the Four Points Sheraton Hotel, Harrisburg, PA. During the morning session committee members will focus on discussion of proactive issues based on annual priorities established by committee members. OMHSAS staff will then lead 6

7 the discussion for reactive issues identified by OMHSAS and requires member feedback. Overtime, prioritized issues established by committee members and co-chairs, will become a part of the reactive session as well. A members retreat will be held during the afternoon session that will afford members an opportunity to develop priorities and goals for the committee. Screening and Assessment Pilot Projects: The Department of Public Welfare through the Office of Children Youth and Families and the Office of Mental Health and Substance Abuse Services funded four pilot projects to conduct the screening and assessment for behavioral health issues of youth in the juvenile justice system. The four counties selected were Allegheny, Bucks, Chester and Erie. Two of the projects include shelters within the county that follow the same guidelines for screening and assessment as the local detention center. Each county has a local team involving the mental health, juvenile justice, courts, and child welfare system that oversees the implementation of the pilot project. Protocols and procedures for the project sites to follow have been established and test data has been collected. A draft report was completed by Dr. Shayne Jones and distributed for review by pilot counties and others involved. The final draft is now under construction and should be available by the end of April. Juvenile Justice (JJ): In 2005, Pennsylvania became the recipient of a grant from the MacArthur Foundation to develop a model system for juvenile justice. One of the three focal areas is mental health. The subcommittee on mental health is focusing on screening and assessment, diversion, developing a continuum of services, and aftercare. A position paper is being developed that delineates the vision of a system that addresses the needs of youth with mental health service needs. Information on the MacArthur Foundation Grant for Juvenile Justice can be found at: The Pennsylvania Juvenile FireSetter Intervention Coalition The Pennsylvania State Fire Commissioner s Office (PA-SFCO), the lead agency for the Pennsylvania Juvenile Fire Setter Interagency Coalition (PA-JFSIC), invited Children s Bureau to with them on a statewide initiative designed to reduce the impact of juvenile fire setting activity in the Commonwealth. The efforts of the Pennsylvania Child Fire Setters (PA-CFS) and Juvenile Arson Task Force (JATF) culminated in the development and distribution of Pennsylvania s first Intervention Protocol for the Prevention and Mitigation of juvenile fire setting. The protocol based on a regional approach to the development of effective Juvenile Fire Setter Intervention programs and heavily on use of the multi-disciplinary team of fire services, law enforcement, juvenile court system, mental health services, and school systems and a county children and youth agency. As 7

8 the initiative is moving in to the implementation phase, Children s Bureau staff will assist in disseminating information to the mental health community, assisting with the two-day regional trainings that will be conducted at six different sites across the state and sitting on the State Fire Commissioner s Advisory Board for the Prevention and Mitigation of Juvenile Fire Setting. At the last regional training, held February 27 and 28, 2006 in the Central Region, about 150 mental health and social agencies were represented. The next training is to be held in the Western Region area in April State Incentive Grant Management Team: Children s Bureau staff are participates on the Bureau of Drug and Alcohol Program (BDAP) State Incentive Grant (SIG) Management Team along with other partnering agencies. At the most recent meeting, members focused on establishing membership to its most recent federally approved State Epidemiological Outcomes Workgroup (SEOW). The workgroup is a component of the Strategic Prevention Framework State Incentive Grant (SPF/SIG). Responsibilities of the workgroup will include collection, analysis and dissemination of public health data on the incidence, prevalence, patterns, and consequences of alcohol, tobacco, and other drug use in Pennsylvania. The SEOW will include a host of individuals that will sustain interagency collaboration. Members will be experienced in epidemiology, substance use prevention, and evaluation. The workgroup will utilize information from local, state, and federal levels to include data that directly relates to SAMHSA s National Outcome Measures. Eventually, this same group will develop a state monitoring and evaluation plan to track the progress of addressing prevention priorities. In the long run, data will be utilized to assess progress and improve prevention efforts. Residential Treatment Facilities (RTF) Cross System Workgroup: The integration of the approval, licensure, and certification of Residential Treatment Facilities (RTFs) is an initiative within DPW. Since 2002 the DPW/RTF Cross System Workgroup has meet regularly to implement a cross system team approach to the review of RTFs through the regional and field offices. The group includes policy, licensing and operational staff from the Office of Children Youth and Families, Office of Medical Assistance Programs including the Bureau of Program Integrity, and Office of Mental Health and Substance Abuse Services. The mission of the group is to establish consistent review and approval of RTFs and to improve the quality of care provided to residents. This group continues to support the Alternatives to Coercive Techniques Initiative (ACT) to address the use of restraints in all residential programs for youth in Pennsylvania. Members of the Workgroup will also contribute to the success of Secretary Richman s charge to the Children s Bureau to developing RTF regulations in a short time frame. Restraint Initiative/Alternatives to Coercive Techniques (ACT): 8

9 The Children s Bureau has continued to be involved in the DPW Alternatives to Coercive Techniques (ACT) Initiative to eliminate the need for the use of restraint through a trauma informed care approach and the use of treatment alternatives in all 3800 licensed programs. This Initiative was launched at a Statewide Leadership Forum on February 1, Participants at the forum included family members, advocates, and providers as well as representatives from interested organizations, counties, State agencies and Departments. The Initiative continued with Regional Forums held in four locations during the first two weeks of April. Statewide over 500 persons attended the regional meeting. The ACT Regional Forums will continue to provide an opportunity for all interested persons to promote trauma informed care and the elimination of coercion and restraint in Pennsylvania s programs for children and adolescents. Families are especially welcome at the Forums where the focus will be on successful endeavors and strategies to address the need to eliminate the use of restraints. Deaf and Hard of Hearing Services: The Children s Bureau has been working with the Department of Education, whose Educational Resources for Children with Hearing Loss (ERCHL) Subcommittee on Mental Health Issues for Children with Hearing Loss has developed a series of recommendations: (1) Establishment of a Residential Facility in the eastern part of the state. (2) Regional trainings (such as provided by PaTTAN), and (3) Regional Outreach Teams. The Children s Bureau worked with a committee of advocates, counties, providers, and Education representatives to establish goals for service development in the South East. One of the outcomes has been a plan for a regional program for residential and related treatment services for children in Southeastern Pennsylvania. The next step for the Children s Bureau is to focus on statewide issues. Childhood Obesity Workgroup: The PA Medical Society has partnered with the PA Departments of Health, Insurance, Public Welfare and several public and private insurers to provide clinicians and their staff the information and resources necessary to screen, identify and treat children that are atrisk for or who are currently overweight. The Department s work group on Childhood Obesity has been asked to participate as a principle partner along with the Pennsylvania Medical Society (PMS) and Congresso of Philadelphia in a new Latino consumer initiative. The program design is based upon the Head-up on Health model. This is a multi-media campaign engaging the community around healthy lifestyle choices, and health related issues. The campaign consists of health cooking and eating program that offers recipe makeover using submissions through a contest sponsored by a Latino newspaper, shopping advise, exercise tips, health screenings, and education around obesity and co-morbidities. Newspapers, media grocers, and other businesses serving the Latino community have expressed great interest and support for this project. 9

10 The various partners have compiled a toolkit that is available to all Pennsylvania clinicians to assist in identifying, treating and referring at risk for overweight and overweight children. An electronic version of the toolkit is presently available on the PA Medical Society website, Service Assurance Pilot: The Service Assurance Pilot is a State Initiative that utilizes telephone based technology to assist in the in-home services quality assurance/quality improvement effort including having verification as to whether or not home and community based services funded by the Commonwealth are appropriately delivered. The scope of the initiative will include approximately 15,000 clients receiving in-home services from various program offices (OMR, Aging, OMHSAS, OMAP and FFS). The system will be implemented on a pilot basis in selected counties. Based on feedback at the conclusion of the pilot stage, the initiative may be expanded statewide. As an update, DPW recently received and reviewed the RFPs from prospective contractors. Currently the team is in the process of reviewing best and final offers from the bidders and selecting a contractor for the pilot. Reactive Attachment Disorder (RAD) OMHSAS staff is identifying selected stakeholders from across the State to participate in a RAD workgroup. Initially this group will focus on development of Guidelines for Good Care and Quality Training for staff, programs and providers of services to youth diagnosed within the broad range of attachment issues, including RAD. This endeavor is considered the beginning of a more expansive review and assessment of how youth with these diagnoses are served. 10